NAVAJO NATION: Health Leaders Target Syphilis Problem on Navajo Nation

Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.

NAVAJO NATION: Health Leaders Target Syphilis Problem on Navajo Nation

Associated Press (01.29.05) - Friday, February 04, 2005
Leslie Hoffman

Two years after public health officials first warned about a syphilis outbreak in the Navajo Nation, experts are still struggling with the challenge of changing people's behavior. "It's the same problem that we've had for the last three or four years: People are having unprotected sex," said Jonathan Iralu, the Navajo Area Indian Health Service's chief clinical consultant for infectious diseases and a physician at the Gallup Indian Medical Center. "I feel like we're doing a lot of good things, but I'm not sure that the common man on the street who's at risk is getting the message."

The outbreak on the country's largest American Indian reservation began in 2000, when nine syphilis cases were reported, a jump from just two in 1999. In 2001, cases increased to 34 and remained at that level in 2002. By 2003, 93 cases were reported. Last year, cases dropped to 71. While the 2004 decrease is promising, the numbers remain too high, said Iralu, who first led the effort to spread the word about syphilis prevention two years ago.

Responding to that call, Navajo President Joe Shirley Jr. defied traditional Navajo taboos about discussing sex in public by encouraging people to practice safe sex and get tested and educated about STDs. Coalitions were forged, education campaigns were launched and screening programs were enhanced. Organizations like the Navajo AIDS Network took to the streets with pamphlets and condoms.

Officials are now focusing their efforts on those at greatest risk for contracting and transmitting syphilis - alcoholics and drug addicts, people who have been incarcerated, and men who have sex with men but may not self-identify as homosexual. CDC medical epidemiologist David Wong's report on the outbreak found that of the syphilis patients, 67 percent of males and 57 percent of females had a history of alcohol abuse. Almost one-third of males with early syphilis reported sex with other men.
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